Susan Lee, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28950 Issued in CA

Practice address

14901 Central Ave
Chino, CA 91710-9500

Phone

(714) 872-6964

NPI assigned

Nov 21, 2012

Reactivated

Aug 7, 2013

Last updated

Mar 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1124362694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14901 CENTRAL AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917109500",
            "telephone_number": "714-872-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 CENTRAL AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917109500",
            "telephone_number": "714-872-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2014-03-10",
        "deactivation_date": "2013-05-09",
        "reactivation_date": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moses Lee
• Robert John Lee
• Serena Lee
• Stephanie Nicole Lee
• Sun Jin Lee
• Tong G Lee, DC
• Legacy Health Services Inc (Legacy Hospice and Palliative Care)
• Stanley Anthony Lemelle, LMFT
• Ho-Yin Leung, D.D.S., M.S.
• Lisle Titilola Lewis, S.L.P.A.

• Clinical Social Worker in Chino, CA
• Providers in Chino, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.